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At least 811 records · Page 45Linked to original sources
PubMed1997

Management of depression in the elderly by general practitioners: referral for psychological treatments.

This study investigates referrals for psychological therapies in general practitioners (GPs) from five catchment areas. The results show that 93 per cent of GPs would consider referring elderly patients for psychological help but only 44 per cent had done so and one in three GPs were unfamiliar with the psychological therapies available. When GPs were asked to select a psychological treatment for depression, 60 per cent chose counselling compared to 21 per cent who chose cognitive-behavioural therapy (CBT). Female GPs particularly favoured counselling. Experience in psychiatry was associated with selection of CBT. The results show that GP training and further education should emphasize psychological therapies. This should make referrals more appropriate and improve patient care.

Aged↗
PubMed1985

Frequent attenders in general practice: medical, psychological and social characteristics.

A group of frequent attenders at a general practice surgery have been studied by comparison with a group of age-and sex-matched controls. Frequent attenders are distinguished by a high predisposition to neurotic illness (as measured by the ;N' score of the Eysenck personality questionnaire) and a high prevalence of affective neurosis. Poor past physical health was commonly found among the frequent attenders and comprised for the most part the common chronic physical illnesses. Of the social characteristics studied only marital breakdown was found significantly more often in frequent attenders than controls.

Adult↗
PubMed1981

Psychological effects of general anesthesia on five- to eight-year-old children.

Thirty-six five- to eight-year-old children undergoing routine myringotomy procedures and maintained with halothane-N2O general anesthesia (mean duration = 17.9 min) were administered a series of psychological performance measures prior to and at about two hours after surgery. A control group of 30 children not experiencing anesthesia or surgery was tested at comparable intervals. In addition, 16 of the anesthesia group and 15 of the control group subjects were retested again the next day, about 24 h postsurgery. The anesthesia group demonstrated impairment on tests of reasoning, motor and memory functions at two hours postanesthesia. There was no evidence for continued impairment 24 h later. The effects at two hours postanesthesia did not appear related to induction medication or group differences in discomfort/symptomatology.

Adaptation, Psychological↗
PubMed1977

Psychological health in general medical practice: a survey.

The information gained from the National Morbidity Survey (1962-63) and the Australia Morbidity Survey (commenced 1969) indicates that there has been a general increase in the number of patients attending a general practitioner for mental disorders. This study was a survey to attempt to gain some insight into the incidence of both primary and secondary emotional/psychological problems in general medical practice. A sample of eight general practitioners completed questionnaires giving information on three areas: (I) Variables of sex, age, marital status and occupation (II) The form and incidence of concomitant somatic/psychological problems (III) The form and incidence of psychological problems. Each general practitioner completed the questionnaire for 200 consecutive patients, giving a total sample of 1600 doctor-patient contacts.

Adult↗
PubMed1992

85-year-olds in Denmark. The socio-psychological conditions and general health and disorders in a representative group of 85-year-old Danes.

A population of persons born in 1897 and resident in Glostrup and eight surrounding municipalities was investigated when these persons were 70, 80 and 85 years old. Some of the results are mentioned from the cross-sectional, epidemiological survey on the socio-psychological conditions and general health and disorders in this representative population which includes almost 2% of the Danish 85-year-olds. The examination programme was extensive, and of data rather comprehensive. The aim of this article is to make known some of the information, observations and results of several tests performed, including 56 different laboratory tests and nutritional analyses. It is worth mentioning that about three fourths of the 85-year-olds were self-reliant and contended with their actual life and lifestyle. Nevertheless suggestions or recommendations for interventions were given to 85% of the participants as well as the general practitioners. The data have already formed the basis of several frames of references.

Aged↗
PubMed1993

An international study of psychological problems in primary care. Preliminary report from the World Health Organization Collaborative Project on 'Psychological Problems in General Health Care'.

This article describes a large longitudinal multicenter collaborative study that investigated the form, frequency, course, and outcome of psychological problems that were seen in primary health care settings in 15 different sites around the world. The research employed a two-stage sampling design in which the 12-item General Health Questionnaire was administered to 26,422 persons aged 18 to 65 years who were consulting health care services. Of these persons, 5604 were selected for detailed examinations using standardized instruments and were followed up at 3 months and 1 year to provide information on course and outcome. All assessment instruments have been translated into 13 different languages. The project has produced a database that allows for the exploration of the nature of psychological disorders experienced by patients in general medical care and their association with physical illness, illness behavior, and disability over time.

Adolescent↗
PubMed2002

General physiology, experimental psychology, and evolutionism. Unicellular organisms as objects of psychophysiological research, 1877-1918.

This essay aims to shed new light on the relations between physiology and psychology in the late nineteenth and early twentieth centuries by focusing on the use of unicellular organisms as research objects during that period. Within the frameworks of evolutionism and monism advocated by Ernst Haeckel, protozoa were perceived as objects situated at the borders between organism and cell and individual and society. Scholars such as Max Verworn, Alfred Binet, and Herbert Spencer Jennings were provoked by these organisms to undertake experimental investigations situated between general physiology and psychology that differed from the physiological psychology advocated by Wilhelm Wundt. Some of these investigations sought to locate psychological properties in the molecular structure of protoplasm; others stressed the existence of organic and psychological individuality in protozoa. In the following decades, leading philosophers such as Friedrich Nietzsche, Charles Sanders Peirce, and Henri Bergson, as well as psychological researchers like Sigmund Freud, integrated the results of these investigations into their reflections on such problems as the nature of the will, the structure of the ego, and the holistic nature of the reactions of organisms to their environment.

Animals↗
PubMedDate not supplied

[Evaluation and validation of a test of psychological distress in a general population in french Quebec].

Psychological distress scales used in epidemiologic surveys usually show high construct validity. The content validation however is less convincing since these scales rest on lists of psychiatric symptoms which are hypothesized as the very content of a psychological distress. This study presents the results of the construct and criterion validation of a new Psychological Distress Manifestations Measure Scale (PDMMS) founded on an initial list of manifestations derived from an original content validation in a general population. Twenty-three items are grouped in four oblique factors with Cronbach's alpha ranging between 0.81 and 0.89. High scores on the scale are correlated with psychoactive drugs consumption, visits to health professionals and self-evaluations of psychological health.

Adolescent↗
PubMed1979

Psychological treatment in general practice.

A clinical psychologist was attached to two group practices in Sheffield for 1.5 sessions each per week. A total of 238 patients was seen during 26 months. Of those completing therapy, 72 per cent made satisfactory progress. In the three months after stopping treatment patients made significantly fewer (36 per cent) visits to the surgeries and received significantly fewer (50 per cent) prescriptions for psychotropic drugs than in the three months before referral. These changes were maintained one year later in the three-month period 12 to 15 months after discharge. The result has been to provide largely successful therapy for a population of patients for whom adequate treatment was previously unavailable. This suggests that it would be worthwhile to expand psychological services in general practice still further as advised by the Department of Health and Social Security.

Adult↗
PubMed2003

Pathways to care and psychological problems of general practice patients in a "gate keeper" and an "open access" health care system: a comparison of Germany and the Netherlands.

BACKGROUND: The comparison of different health care systems is one way to give empirical evidence to health care reform and policy. The differences between health care systems in which general practitioners serve as gate keepers in comparison to systems in which patients are free to contact every physician and specialist they like are a question of high interest. METHOD: This study compares the Netherlands and Germany, two countries with very similar political, social, and health system structures, but different types of access to the health care system. While Germany offers unconstrained access to specialist ambulatory care, the Netherlands restricts health care utilization by giving primary care a 'gate keeper' function not allowing patients direct access to specialist care. Data from the WHO international collaborative study on psychological problems in general health care (Ustün and Sartorius 1995) were analysed with respect to pathways to care, treatment, and health status. In an initial cross-sectional assessment, in 3-month and 12-month follow-ups, contacts to physicians or hospital admission have also been monitored. RESULTS: There were only marginal differences between the Dutch and the German sample in the sociodemographic characteristics as well as in the diagnostic status with respect to mental disorders. In the Netherlands, 95.5%, and in Germany, 68.8% of the patients presented their 'reason for visit' for the first time to any physician at this index contact with a general practitioner. During the following 3 months, 24% of the Dutch patients, but 60.2% of the German patients, additionally contacted other physicians ( P < 0.001). At 12 months, this rate was 62.9% vs. 78.6% ( P < 0.001). During the 12-month follow-up period, there were 15.7 0/00 hospital admissions in Germany vs. 25.4 0/00 in the Netherlands ( P < 0.005) [corrected]. CONCLUSIONS: Family physicians in a gate keeper system reduce the number of contacts to other physicians and the intensity of treatment, while at the same time the rate of hospital admissions is increased.

Adolescent↗
PubMed1992

Perceptions of psychological problems in general practice: a comparison of general practitioners and psychiatrists.

All general practitioners and psychiatrists working in a single health district were sent a questionnaire on their perceptions of the prevalence of psychological problems among patients consulting in general practice. One hundred and twenty-one GPs (75%) and 10 (83%) psychiatrists responded. GPs and psychiatrists agreed that up to 20% of consulting patients were likely to be clinically depressed; they also agreed on the most appropriate management, although GPs tended to be more conservative than psychiatrists would advise on making use of hospital services. GPs, however, believed non-specific psychological problems to be significantly less common than did psychiatrists. This expectation may help explain the reported failure of GPs to diagnose all psychological problems identified by formal psychiatric instruments.

Adult↗
PubMed1998

A survey of job satisfaction, sources of stress and psychological symptoms among general practitioners in Leeds.

BACKGROUND: The past seven years have seen rapid changes in general practice in the United Kingdom (UK), commencing with the 1990 contract. During the same period, concern about the health and morale of general practitioners (GPs) has increased and a recruitment crisis has developed. AIM: To determine levels of psychological symptoms, job satisfaction, and subjective ill health in GPs and their relationship to practice characteristics, and to compare levels of job satisfaction since the introduction of the 1990 GP contract with those found before 1990. METHOD: Postal questionnaire survey of all GP principals on the Leeds Health Authority list. The main outcome measures included quantitative measures of practice characteristics, job satisfaction, mental health (General Health Questionnaire), and general physical health. Qualitative statements about work conditions, job satisfaction, and mental health were collected. RESULTS: A total of 285/406 GPs (70%) returned the questionnaires. One hundred and forty-eight (52%) scored 3 or more on the General Health Questionnaire (GHQ-12), which indicates a high level of psychological symptoms. One hundred and sixty GPs (56%) felt that work had affected their recent physical health. Significant associations were found between GHQ-12 scores, total job satisfaction scores, and GPs' perceptions that work had affected their physical health. Problems with physical and mental health were associated with several aspects of workload, including list size, number of sessions worked per week, amount of time spent on call, and use of deputizing services. In the qualitative part of the survey, GPs reported overwork and excessive hours, paperwork and administration, recent National Health Service (NHS) changes, and the 1990 GP contract as the most stressful aspects of their work. CONCLUSIONS: Fifty-two per cent of GPs in Leeds who responded showed high levels of psychological symptoms. Job satisfaction was lower than in a national survey conducted in 1987, and GPs expressed the least satisfaction with their hours, recognition for their work, and rates of pay. Nearly 60% felt that their physical health had been affected by their work. These results point to a need to improve working conditions in primary care and for further research to determine the effect of any such changes.

Adult↗